SURGERY, PSYCHOLOGICAL FACTORS, BLOOD CLOTTING FACTORS IN WOMEN GYN PROCEDURES

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 背景： 卵巢癌是最致命的生殖道癌症，在手术清除卵巢癌后，女性患静脉血栓栓塞症(VTE)的风险增加，这几乎是所有患者的主要治疗方法。 这种VTE事件的经历可能导致严重的发病率和猝死，但在很大程度上仍然是不可预测的。来自实验心理生物学文献的证据已经证明了心理应激对凝血因子的影响，但这项新兴研究的意义尚未在手术患者中确定。考虑到卵巢癌患者在手术前报告的高水平的痛苦，确定痛苦可能对增加VTE风险的凝血因子所起的作用是重要的。 目标/假设： 本研究的目的是前瞻性地评估术前心理困扰对术后凝血因子的影响。假设手术前较高水平的情绪困扰(例如，情绪不安)以及背景心理变量(例如，应对方式)都将预测手术后凝血反应的增强(即，血液中D-二聚体、纤维蛋白原、PAI-1水平的增加)，并控制人口统计学和医学变量。 进一步的假设是，虽然消极的心理变量可能会增强手术后的凝血反应，但积极的心理变量可能会减弱这种反应。这项研究还将从统计学上探索状态、特征和背景心理变量对术后血栓形成危险因素的血液水平可能产生的独特和综合影响。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Background: Women with ovarian cancer, the most deadly cancer of the reproductive tract, are at a heightened risk for developing a venous thromboembolism (VTE) after surgical debulking, the primary treatment for virtually all patients. The experience of such a VTE event can result in significant morbidity and sudden death, yet remains largely unpredictable. Evidence from the experimental psychobiology literature has demonstrated effects of psychological stress on coagulation factors, but the implications of this emerging research has yet to be determined in surgery patients. Given the high levels of distress reported in ovarian cancer patients prior to surgery, it is important to determine the role distress may have on coagulation factors that increase risk of VTE. Objective/hypothesis: The purpose of the proposed research is to prospectively assess the effect of preoperative psychological distress on postoperative coagulation factors. It is hypothesized that both higher levels of emotional distress immediately prior to surgery (e.g., emotional upset) as well as background psychological variables (e.g., coping style) will predict heightened coagulation responses to surgery (i.e., increased blood levels of D-Dimer, fibrinogen, PAI-1), controlling for demographic and medical variables. It is further hypothesized that while negative psychological variables may enhance to coagulation response to surgery, positive psychological variables may attenuate it. The study will also statistically explore possible unique and combined effects of state, trait and background psychological variables on postoperative blood levels of thrombosis risk factors.